Prostate cancer

Definition

Prostate cancer is cancer that starts in the prostate gland. The prostate is a small, walnut-sized structure that makes up part of a man's reproductive system. It wraps around the urethra. This is the tube that carries urine out of the body.

Alternative Names

Cancer - prostate; Biopsy - prostate; Prostate biopsy; Gleason score

Causes

Prostate cancer is the most common cause of death from cancer in men over age 75. Prostate cancer is rarely found in men younger than 40.

People who are at high risk include:

African American men, who are also more likely to develop this cancer at every age

Men who are older than 60

Men who have a father or brother with prostate cancer

Other people at risk include:

Men who have been around Agent Orange

Men who use too much alcohol

Farmers

Men who eat a diet high in fat, especially animal fat

Obese men

Tire plant workers

Painters

Men who have been around cadmium

Prostate cancer is less common in people who do not eat meat (vegetarians).

Exams and Tests

A biopsy is needed to tell if you have prostate cancer. A biopsy is a procedure to remove a sample of tissue from the prostate. The sample is sent to a lab for examination. It will be done in your doctor's office.

The biopsy result is reported using what is called a Gleason grade and a Gleason score.

The Gleason grade tells you how fast the cancer might spread. It grades tumors on a scale of 1 through 5. You may have different grades of cancer in one biopsy sample. The two most common grades are added together. This gives you the Gleason score. The higher your Gleason score, the more likely the cancer can spread beyond the prostate:

Scores 2 through 5: Low-grade prostate cancer.

Scores 6 through 7: Intermediate- (or in the middle) grade cancer. Most prostate cancers fall into this group.

Scores 8 through 10: High-grade cancer.

The following tests may be done to determine whether the cancer has spread:

If you are older, your doctor may recommend simply monitoring the cancer with PSA tests and biopsies.

If the prostate cancer has spread, treatment may include hormone therapy (medicines to reduce testosterone levels). It may be used for all but the earliest stage of prostate cancer. It may be given before, along with, or after other treatments.

If prostate cancer spreads even after hormone therapy, surgery, or radiation has been tried, treatment may include:

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